BACKGROUND: Gastrectomy is the most effective treatment for a variety of gastric tumors. Gastrectomy, nevertheless, can lead to significant gastrointestinal symptoms. As minimally invasive surgery has advanced, laparoscopic gastrectomy is advocated as a treatment method with equivalent pathologic results, with faster recovery. However, very little data exists using objective, validated instruments of gastrointestinal symptoms for either laparoscopic and open gastrectomy. This study compares the laparoscopic and the open gastrectomy for short term morbidity, hospital length of stay and also long term gastroinetestinal symptomatolgy. METHODS: Patients who have undergone gastrectomy had their medical records were reviewed for demographic data, type of gastrectomy, and short term morbidity, and hospital length of stay. Patients were contacted and asked to complete the Gastrointestinal Symptom Rating Scale (GSRS). The GSRS measures three domains of GI symptoms: dyspepsia Syndrome (DS) for the foregut (best score 0, worse score 15), indigestion syndrome (IS) for the midgut (best score 0, worse score 12), and bowel dysfunction syndrome (BDS) for the hindgut (best score 0, worse score 16). Statistical analysis was done using the Mann-Whitney U-test.RESULTS: We had complete data on 32 patients: 7 laparoscopic and 25 open. Of these, 25 had a gastroenteric anastomosis and 6 did not. The table shows the results as medians with interquartile range.CONCLUSION: Overall, patients have relatively little adverse gastrointestinal symptoms in any of the types of gastrectomies in any of the GSRS domains. This implies that most patients return to relatively good gastrointestinal function after gastrectomy. Patients with laparoscopic gastrectomy had slightly better median score in the DS domain compared to the open technique, while patients who had gastrectomy without an anastomois had better median score in the IS domain. Implying that an anastomosis an mild adverse midgut effects.

GSRS Domain	Open Gastrectomy	Laparoscopic Gastrectomy	p-value
Dyspepsia Syndrome	1 (0-3)	0 (0-3)	0.02
Indigestion Syndrome	1 (0-2)	0 (0-2)	NS
Bowel Dysfunction Syndrome	2 (1-4)	1 (0-4)	NS
	Partial Gastrectomy with Anastomosis	Partial Gastrectomy without Anastomosis
Dyspepsia Syndrome	1 (0-3)	0 (0-1)	NS
Indigestion Syndrome	1 (1-4)	0 (0-1)	0.05
Bowel Dysfunction Syndrome	2 (1-4)	1 (0-1)	NS